exam 1 Flashcards
BUN labs test?
kidney function
CO2 labs test?
blood bicarbonate level
creatinine labs test
kidney function
bilirubin labs test
liver function
albumin labs test
liver function
hypovolemia is
decrease in blood volume due to body fluid or blood loss
ADH is also known as
vasopressin
potassium normal range
3.5-5
sodium normal
136-145
calcium normal (call police)
9-11
magnesium normal (magnifying glass)
1.5 to 2.5
hypokalemia is critical for adult s when below
3
which medication most commonly can cause hypokalemia
potassium-wasting diuretics
what type of monitoring should a patient be on when being given IV potassium
ECG monitoring
most common cause of hyperkalemia
renal failure
hemodialysis is
filtering waste from blood using a machine
medication that most commonly causes hyponatremia
thiazide diuretics
medications that cause hypocalcemia
-stimulant laxatives
-long term glucocorticoid use
-loop diuretics
function of PTH
maintain proper amount of calcium in body
osteopenia is
low bone mass
osteopenia is caused by
hypocalcemia
cardio manifestations of hypocalcemia
chest pain
dysrhythmia
heart failure
syncope
neuromuscular manifestations of hypocalcemia
-numbness/tingle in fingers, toes & around mouth
-muscle cramp
-back/LE spasms
neurologic manifestations of hypocalcemia
confusion
depression
psychosis
dementia
lethargy
seizures
personality changes
resp manifestations of hypocalcemia
wheezing
spasms of larynx & airway
dysphagia
voice changes
integumentary manifestations of hypocalcemia
coarse hair
hair loss
brittle nails
dry skin
itching
chvostek sign
tap cheek
twitching=positive
trousseau sign
inflate blood pressure cuff to 20 above pts systolic BP for 3-5
hand/finger flex=positive
most common causes of hypercalcemia
hyperparathyroidism
cancer
hypercalcemia manifestations mnemonic
abdominal moans
painful bones
kidney stones
groans
neurologic overtones
hypotonic treats
hypernatremia
diabetic ketoacidosis
monitor for what when giving hypotonic
hypotension
dont give hypotonic to
burn pt
liver disease
increased intracranial pressure
type of hypotonic solution
0.45% NaCl
hypertonic solutions
-3% sodium chloride
-dextrose 5% in 0.45% sodium chloride (D51/2NS)
-dextrose 5% in 0.9% sodium chloride solution (D5NS)
-dextrose 5% in lactated ringers solution (D5LR)
-dextrose 10% in water (D10W)
3% sodium chloride treats
cerebral edema
symptomatic hyponatremia
D51/2NS used for
maintenance IV fluid
hypovolemia
monitor D51/2NS for
fluid overload
D5NS used to
provide electrolytes, water and calories
monitor D5NS for
fluid overload
D5LR used to
provide calories, electrolytes, and water
treat metabolic acidosis
D10W used for
hypoglycemia
provides calories and water
D10W precautions
-use central line (avoid phlebitis or thrombosis)
-infuse slowly (avoid hyperglycemia, fluid overload, pulmonary edema)
monitor D10W for
new onset confusion or loss of consciousness
hypertonic solutions are contraindicated in
cardiac or renal disease
isotonic solutions
0.9% sodium chloride (NaCl)
Lactated ringers (LR)
Dextrose 5% in water (D5W)
NaCl is used for
IV fluids for vomiting, diarrhea, hemorrhage and shock
LR are used for
burn & trauma
hypovolemia
acute blood loss
electrolyte imbalance
metabolic acidosis
use LR cautiously w
renal failure pt
D5W is used for
hypernatremia
D5W contraindicated in
resuscitation
early pre-op period
renal & cardiac issues
increased intracranial pressure
peripheral catheters range from
14-24 gauge
catheters become narrow as
the gauge number increases
CVAD are flushed with what to prevent clots
saline or low concentrated heparin
manifestations of phlebitis
-pain at site
-swelling
-redness
-fever
-palpable cord along vein
vesicants are
irritating to veins
pH of 0 is
strongly acidic
pH of 14 is
strongly alkaline
pH of 7 is
neutral
pH lower than 7 is
acidic
pH higher than 7 is
alkaline
expected pH range
7.35-7.45
arterial blood gas (ABG) labs test
acid base balance in body
PaCO2 is
partial pressure of carbon dioxide
HCO3- is
bicarbonate
PaCO2 range
35-45
HCO3- range
21-28
PaO2 range
80-100
O2 sat range
95-100
high acidity = ____ pH
low pH
high alkalinity = ___pH
high pH
acidosis is
high acid
alkalosis is
high alkaline
acidosis =
low pH
alkalosis =
high pH
high PaCO2 =
respiratory acidosis
low PaCO2 =
respiratory alkalosis
low HCO3- =
metabolic acidosis
high HCO3- =
metabolic alkalosis
metabolic = abnormal __
HCO3-
respiratory = abnormal __
PaCO2
resp acidosis causes
CNS depression
pulmonary diseases
resp alkalosis caused by
hyperventilation
diarrhea causes
metabolic acidosis
blood can be administered over
1-4 hrs
action for starting IV for pt with high bleeding risk
apply BP cuff set to 30 mm Hg to protect from bruising and bleeding
extravasation is
when vesicant med or fluid gets into surrounding tissue
circulatory overload can cause
weight gain
reviewing labs is what step in nursing process
evaluation
O+ blood types can only receive blood from
other type O blood types
A- blood types can give blood to
A+, A-, AB-, AB+
PICC lines are inserted into
large veins
hypoxia is
low O2
malignant hyperthermia is
sever rxn to meds given during anesthesia
tobacco use before surgery puts pt at risk of
blood clots
MI
death
infections
slow wound healing
PACU stands for
post anesthesia care unit
atelectasis is
collapse of lung during expansion
dehiscence is
wound opens up
treatment for dehiscence
antibiotics
frequent dressing changes
keeping wound open
evisceration is
organs coming out of wound
oliguria is
low urine output
why are pts NPO before surgery
to decrease intraoperative vomiting and aspiration
condition that places pt at risk for life threatening event during surgery and requires prophylactic measures
malignant hyperthermia
hydration after surgery decreases risk of
clots
cardiovascular complications
footwear recommended for post op pts
nonskid footwear
organization that promores surgery pt safety
association of perioperative RN (AORN)
regional anesthesia affects
area of body
local anesthesia affects
motor and sensory nerves at surgical site
epidural anesthesia is used for
abdominal and thoracic surgeries
devices prescribed to decrease VTE risk
sequential compression devices
scrubbing surgical site steps
- scrub in circle w antiseptic
- start at center and move outward
- scrub outer edge and throw away sponge
- repeat process w new sponge
- drape client
ileus is
post op abdominal surgery complication w decreased bowel sounds, nausea, discomfort
hospice care
dying patients w under 6 months to live
hospice is generally delivers in
pts home or family home
respite care
support for family/caregivers
palliative care
care for patients approaching death or that have chronic illness
alzheimers and parkinsons fall under
palliative care
death rattle is
sound of retention of secretions in respiratory tract
cheyne-stokes respiration
breathing pattern cycles that start w rapid shallow breaths and increase to deep breaths ending w apnea
apnea is
breathing starts and stops during sleep
3 step ladder of palliative care pain management
nsaids
codeine or tramadol
morphine
nonpharmacologic interventions for pain
diversion
relaxation exercises
massage therapy
mottling is
purple/red marbling in skin before death
how to manage mottling
provide warm blanket
how to manage cheyne stokes respirations
have fan blow in pt direction
how to manage hallucinations
reassurance
avoid denial of sensations
how to manage death rattle
turn pt on their side
identification tags should be placed on a minimum of
2 areas of the pts body
prolonged grief lasts
longer than 6 months
disenfranchised grief is
grief when pet dies
wordens 4 tasks of mourning
accept
acknowledge
adjust
reinvest
isotonic range
270-300 mOsm/L
hypertonic range
> 300 mOsm/L
hypotonic range
<270 mOsm/L
dehydrated rnage
> 300 mOsm/L (hypertonic)
symptoms of dehydrationn
fever
low BP
high pulse
hyperkalemia causes
arrhythmias
is vitamin k potassium
no
hypokalemia risk factors
diuretics
excessive laxative use
nausea & vomiting
NG tube
hyperkalemia risk factors
spironolactone
kidney disease
high potassium diet
-pril meds
-sartan meds
ACE inhibitors
ARBs
salt substitutes (contain potassium)
calcium relaxes
heart
muscles
hypercalcemia symptoms
bradycardia
drowsiness
fatigue
lethargy
hypocalcemia symptoms
seizures
tachycardia
restlessness
where would a bed ridden patient have edema
sacrum area
how does insulin affect potassium
decreases potassium
pedialyte is a form of what therapy
oral rehydratoin therapy
can you give oral rehydration to vomiting pt
yes still absorbed
pH of 1 is
most acidic
pH of 14
most alkaline
ph of 7.0
neutral
what organs control pH
kidneys
lungs
how many liters of oxygen can a COPD get
no more than 4 L
phlebitis
vein inflammation
infiltration
when IV solution leaks into tissues around vein
thrombosis
blood clot formation
how long can you leave SPC cath
72 hrs
Midline cath timing
2-4 wks
indication of nerve puncture
pins and needles sensation
